For What It’s Worth: ‘There Are Legitimate Reasons To Be Hopeful About 2022’

Dr. Irwin Redlener.

You may have seen him on MSNBC where he is a public health analyst — or in Tal’s where he loves to buy bagels. Upper West Sider Dr. Irwin Redlener is a nationally known pediatrician, founding director of the National Center for Disaster Preparedness at Columbia University, and professor of pediatrics at Albert Einstein College of Medicine. He is also co-founder — with his wife, Karen, and singer/songwriter Paul Simon — of the Children’s Health Fund, a nonprofit that has provided health care to underserved children since 1987, and, now, a columnist for West Side Rag.

You provide questions in the comments and he’ll provide as many answers as possible in his weekly column: For What It’s Worth, appearing on Tuesdays. Please be aware that Dr. Redlener cannot give specific personal medical advice. For that you need to consult your regular physician. The views expressed here are Dr. Redlener’s, not endorsed by West Side Rag.

By Dr. Irwin Redlener

So here we go. Out with 2021, in with 2022. It’s tough to know where to start saying good riddance to a pretty rough year, as years go.

So where are we and what can we expect? Just remember that whatever any expert says or whatever guidelines are proposed by the government about Covid-19 today, recommendations could change — and probably will change — as new data and insights become available.

That said, I really do believe that for those who are fully vaccinated, there are legitimate reasons to be hopeful that the 2022 version of the Covid pandemic will be less unsettling, less dangerous than what we went through last year. I say this well aware that Covid-19 is a wily virus fully capable of changing shape (mutating) and altering its impact on human health.

Keep in mind that whatever variant, Delta or Omicron, predominates in 2022 – including the possibility that a new variant may emerge – there are some serious caveats that must be reinforced if we are to optimize our chances of staying healthy and safe in the new year.

First, we absolutely can’t let up on getting everyone fully vaccinated – by which I mean at least three appropriately spaced jabs. Feel like you’d like to skip that “booster” or third shot? Forget it. Two jabs is just not good enough. Sorry.

Not vaccinated? Please reconsider. You are taking a serious personal risk and if you go to the hospital, you will potentially expose every health care worker who cares for you to the virus. And if you get admitted, you’ll take up a hospital bed and use staff that could otherwise be assigned to caring for seriously sick or injured patients who may not have Covid-19, but have other conditions that need urgent care.

Secondly – and I know this is tough – we will need to have vaccine passports for travel.  Covid is biological wildfire. In my opinion, nobody should be allowed to board an airplane, train (or bus for that matter) without proving that they are vaccinated.

Third, don’t let up on pressing all the political buttons you have access to, pushing unrelentingly to make sure that the U.S. gives more — much more — to making sure the entire world is vaccinated. There are countries in Africa that have vaccinated less than 3% of their populations. Terrible for citizens of those countries. But it sucks for us, too. Every under-vaccinated community in Ethiopia (or Florida or western Minnesota, for that matter), is a breeding ground for potentially virulent mutations. They will eventually find us! You just can’t hide from a mad pandemic virus.

Finally, I want to share a perspective with you about the concerns – and widespread confusion – about the Covid-19 delta variant versus omicron. This is not yet well described, but here’s what I think: On an individual clinical basis, the delta version is a rapid spreading, multi-system attack machine that damages small blood vessels and is capable of infecting your lower respiratory system. Think lungs and pneumonia. It can and often does render unvaccinated victims seriously ill, intubated in the ICU or dead.

While the omicron variant is a wildly transmissible infection that seems to be somewhat resistant to vaccines, it does not usually attack the lungs, as far as data suggests today. It can still make you sick with severe “cold-like” symptoms, but is way less likely to kill you or land you in the ICU.  At least that’s what seems to be the case at the moment.

The key message is that to avoid getting very sick from either variant. You need the initial vaccine series, plus a booster (mix and match OK). And you may well need a fourth shot. Stand by! (Remember: 2, 3 or 4 shots do not, will not, guarantee that you won’t get sick from Covid-19. They just represent your best hope of avoiding an ICU admission– or worse – if you get infected.

By the way, Covid-19 rapid testing does not differentiate among variants; only specialized labs have those capabilities. When we see predominantly “upper respiratory” symptoms (sneeze, congestion, sore throat, cough, and so on) in a patient, we assume that the patient probably is dealing with the omicron version — especially if that’s the variant running wild in the community.

So that’s it for this week. Stay healthy, be careful and try to stay engaged and fulfilled in 2022!

You can follow Dr. Redlener on Twitter: @IrwinRedlenerMD

 

COLUMNS | 28 comments | permalink
    1. Marilyn says:

      Dr. Redlener, what is known about immunity once a person has been infected with either the Omicron or Delta variant? Thanks for doing this column.

    2. Jay says:

      This is “optimism?” A politicized push to vaccinate the entire world? What if the “entire world” doesn’t agree with your assessment? Vaccine passports for travel? Push political buttons at every chance?

      This is why I left New York, this kind of monomaniacal focus on nRNA vaccines. Who is paying this guy to spread his optimism?

      • Jay says:

        And I know, I probably “sound like a right wing anti-vaxxer.” Sorry, I’m a life-long liberal musician and artist who lived on the Upper West Side for 30 years and left New York with many regrets because I am against vaccine passports and vaccine mandates, and found it impossible to stay. I am “in the vulnerable group” as a 57 old type 1 diabetic, and have been absolutely fine throughout this whole thing, following the minimal covid security theater requirements, and instead focusing on enhancing my own health and immune system.

        • Don Kedick says:

          The best way to “enhance your own immune system” is to take the vaccine. That’s what it does, that’s what it’s for. It’s safe and effective.

          Plenty of once healthy people are now dead from COVID. But we can keep others from sharing that same fate, by getting the shot, and with vaccine mandates and passports. That’s how we New Yorkers keep each other safe.

        • Sybil says:

          So…yeah, Jay, you’re an anti vaxxer.

          • Jay says:

            I really cannot believe how thoughtless and cruel so many of those on the left have become. Wilfully ignorant as well.

            Dr. Redlener actually seems sincere in his beliefs here, I’ll give him that.

            But as a “patient” who has seen his fair share of hospital insides, and doctor’s offices, I’ve learned to be patient with my doctors. If I’d listened to the dietary recommendations of the ADA and my doctor I’d probably be missing a toe by now, partially blind, or worse. A diet that leans Keto has been a lifesaver for me, my doctor in NY, nice as she is, considered it kookoo, even though she was amazed at my blood sugar numbers when I followed it.

            Many, many people who have actual chronic diseases or autoimmune diseases have learned to take what is good from allopathic medicine and leave the rest, and find more natural ways to be healthy. Toxic drugs with side effects are ALWAYS the LAST choice, not the first. Vaccines have their use as a tool, but to push them with a monomaniacal focus on the entire world, as is being done here, is reckless, especially given that it is still in its testing phase and incorporates sophisticated medical technology that has never been approved for human use until now.

            • EricaC says:

              I don’t think those comments were cruel – they said you were anti-vaxx. You are – your comment is explicitly anti -vaxx. Where’s the cruelty?

              And yes, i have an autoimmune disease, and yes, I gratefully received three doses.

    3. Concerned Parent says:

      We are seeing an uptick of kids in the ICU “with COVID” but it’s not clear whether those kids are in the ICU for other reasons and simply testing positive for COVID, or whether we are now seeing more children with severe COVID symptoms. As a pediatrician, what is your take?

    4. Lisa says:

      I just had what I presume is Omicron. Why can’t we distinguish between variants with our tests? Obviously it’s medically possible, or we wouldn’t even know about Omicron or Delta or any other variant.

    5. Sb says:

      Dr.—is there any data from clinical trials about the effects of multiple mRNA jabs on the immune system and organs?
      Will we have to booster for the rest of our lives?
      Also Africa seems to be doing ok since it is younger and not obese so why the focus there?

    6. Alistair says:

      I spent a lot of my career working with doctors. Never have I heard so many of them say things to the effect of, “we are in uncharted territory, there is no roadmap, or solution”. The good doctor here is right. Drastic measures must be designed and enforced. This country went to war for 20 years because three thousand people died. We’re nearing a million deaths from COVID and Republicans shrug. Protecting the country means more than just shoveling money into the military industrial complex.

    7. AK says:

      Look, I am vaccinated so let’s just get that out of the way. To say nobody should be allowed to not have a vaccine to travel or do other normal activities is absurd. My dear friend almost died from previous non-covid vaccines, her body hemorrhaged for several days after her last routine vaccine. Her doctor told her under no circumstances can she get the covid vaccine. She is not the only one I’m sure. There has to be exceptions for people whose body cannot handle vaccines. Period.

      • Don Kedick says:

        It’s exactly to protect people like your friend that EVERYONE ELSE needs to get vaccinated. It’s an incredibly selfish, unfair choice to forego the vaccine and spread the virus when we have people who cannot protect themselves from it.

        • AK says:

          If you can safely get the vaccine then great, good for you. But to make people who are physically not able to get the vaccine pariahs of society that cannot go out to eat inside a restaurant or get on a plane is outrageous.

    8. The mandate-it versus don’t-step-on-me war seems unlikely to end in anybody’s lifetime. If we like peace, we should seek solutions that satisfy both sides in this war. One would be optional mandates. E.g., some subway cars, airplanes, and restaurants are limited to the vaccinated, but not all. Otherwise, migration is accomplishing that as people seek places populated by people like them, and, if that trend moves far enough, it might lead to successful secession movements.

      • Don Kedick says:

        “Both sides” is a terrible position to take when one side refuses to engage with reality. Yes, the anti-vaxxers will not be happy if they don’t get their way. But any compromise with their harmful position means people die preventable deaths.

        Now, we could be like you, and say we’ll take some hurt feelings, and some preventable deaths, since that’s a balanced compromise.

        But that’s an abhorrent choice, and an act of complete moral cowardice. Don’t fall for it.

        “We have to let them hold us hostage or they’ll do something even worse” is naked appeasement, and it never works. We can fight for public health and we can fight against insurrection, we don’t have to sacrifice one to try to stave off the other.

        • Don says:

          What on earth are you talking about? Why do you care if people are vaccinated or not? Unvaxxed people are taking a higher risk with their lives, and that’s their choice. So what.

          • cpwpj says:

            So it’s about the common good, Don. The more unvaccinated, the more inevitable the spread of Corona virus, especially since in some people it’s asymptomatic. We shouldn’t be taking sides. It’s in everyone’s interest to keep fellow Americans as safe as possible.

    9. JS says:

      So nice to see your new columnist at the WSR. I look forward to reading his future columns.

    10. DemCrazyDems says:

      Get vaccinated if you want but don’t push it on everyone else. Find your ‘hope’ elsewhere. If vaccines work (which obviously they do not in all situations – which kills the insistence on people mandating all get vaccinated) then you need not worry and can go forth. Quit controlling people’s freedoms not to vaccinate. How about encouraging people to exercise, eat healthfully, get Vitamin D, do saunas, boost immunity?

      • Don Kedick says:

        Your “freedom not to vaccinate” is just as relevant as your “freedom to blow cigarette smoke in a child’s face” — which is to say, you don’t get to do that even if you really really want to, because you’re putting someone else in danger of serious health consequences. This is a PANDEMIC, everyone’s health is at risk. Pretending that vaccines are a personal choice is ignorant at best, malicious at worst.

        And offering vitamins and saunas as an alternative? It’s like you want the pandemic to get worse. But I suppose that’s par for the course with someone who calls themself “DemCrazyDems”.

      • NYYgirl says:

        Can you share a study (and its source) about the people who “exercise, eat healthfully, get vitamin D, do saunas, boost immunity” and what percentage of those people were seriously ill, have long Covid, or died? Or the outcomes of the unfortunate ones who could not be protected from those people? And then, please trade places with a health care worker for a day. After you are fully vaccinated and boosted.

      • rteplow says:

        I have to disagree with you that vaccines don’t work. The vaccine doesn’t provide 100% protection against getting the virus, but it is overwhelmingly effective at keeping you out of the hospital and dying from the virus. Please look at the statistics.

    11. Dr. Redlener says:

      Hello neighbors,
      Thanks, all for your comments.,
      So, folks, we are indeed seeing a serious uptick in kids being admitted to hospitals with Covid, both because of Covid – and Covid as an incidental finding for a child with some other diagnosis. But pediatric cases are rising in our state and also filling up children’s hospitals across the nation. And, Lisa, differentiating among variants cannot be done with routine diagnostic tests. It must be done in special labs that can do what’s called genomic sequencing. Right now we presume which variant you have based on clinical symptoms and what seems to be prevalent in the community. Not a great answer, I admit. But that’s all we have right now.
      Good question, Sb. Three jabs are fine and appropriate since immunity seems to wane some months after the second mRNA shot (Moderna or Pfizer). A fourth shot may be in the works – and possibly even an annual booster! By the way, yes, there is some “natural” immunity after you have the disease – but it is nowhere near the protection we get from having the disease in addition to getting vaccinated.
      OK. Now to you, Jay. We need a heart to heart – starting with appreciating what your fellow commenter, Don Kedick has to say. Many of my colleagues and I are pushing for national vaccine passports and vaccine mandates for boarding planes and trains. Why, you ask? Because vaccines are the single most powerful weapon we have to fight the pandemic. Full stop. My suggestion? Stop reading those crazy conspiracy websites, get vaccinated and come back to NYC! And seriously, think about this: if your refusal to get vaccinated only puts you at risk, well I’d say, “OK Jay. Good luck to you, I hope you dodge the bullet”. But your behavior is putting others at risk. And that’s not OK. If you get Covid-19 and go to the hospital you are taking up a bed and exposing many health worker heroes to a potentially fatal illness. Really NOT OK – just kind of selfish; and I know that’s not like you.

    12. John says:

      Hi, Dr. R, really appreciate your new column and sage advice (including the comments). Question on behalf of some friends triply vaxxed but who got COVID (presumably omicron variant): I’ve heard one can continue to test positive for weeks or longer, even once symptoms have more or less vanished. I gather that they’re saying 5 days or so to remain quarantined once deemed positive (on account of the amount of time one might be considered contagious), but what is the best behavior required of those — past the 5-day period — to resume semi-normal things, like eating in a restaurant or gathering with friends/family/colleagues indoors? Perhaps asked another way: what are the short- and long-term recommendations for those who have (or have recently had) COVID?

    13. words matter says:

      Please confirm or clarify this statement:

      While the omicron variant is a wildly transmissible infection that seems to be somewhat resistant to vaccines…

      Is is resistant to all potential/future vaccines or just the few that we currently have? I think your statement is way too broad.

    14. Tanya W. says:

      Dr. Redlener,

      Thank you for posting here! One question I’ve had is it seems in doctor’s offices and hospitals (outside of COVID wards), only surgical-type masks are worn by the staff and doctors, which seem to have pretty significant gaps at the sides. Why aren’t N95 or KN95 masks being used in medical settings? I’ve heard that they need to be fitted, but wouldn’t an un-fitted KN95 that fits snugly around the face be better than a gappy surgical mask? I use KN95s bought on Amazon and feel more secure using them. Also maybe I’m weird (or they’re defective, ugh!), but I can breathe reasonably well through them.

      Thanks again!

    15. Charlotte says:

      Dear Dr. R,

      Could you explain the correct ways to use testing? I know it’s important, but I’m a little unclear about why it’s considered the “solution” to the pandemic.

      Thank you,

      Charlotte